Organization
PHILLIPS HOSPITAL CORPORATION
Active
Parent organization
PHILLIPS HOSPITAL CORPORATION
Other names
Marvell Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHILLIPS HOSPITAL CORPORATION
Authorized official
LAURA HOLSFORD (AUTHORIZED OFFICIAL)
(615) 465-7466
Entity
Organization
Contact information
Practice address
1008 MAIN ST, MARVELL, AR 72366
(870) 829-2521
Mailing address
PO BOX 848092, DALLAS, TX 75284-8092
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10085
BCBS
—
05
—
1495414729
—
AR
Enumeration date
03/08/2006
Last updated
06/19/2008
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